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Migraine Prevention Medications
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Timothy Collins, MD posted:
Which medications work for migraine prevention? This question comes up all the time, so I've made a list of some of the medications we use for headache prevention, along with a little information about the medication.

The dose is important, so your doctor has to be familiar with both the "normal" dose and the maximum dose. (A dose that is too small may not work, even if you take it for a long time)


Propranolol--this is a "betablocker" type of blood pressure medication. Atenolol and nadolol are similar medications

Verapamil--this is a "calcium channel blocker" type of blood pressure medication. We usually prescribe the 24 hour long lasting capsules, but it comes in a less expensive immediate release version.

Divalproex Sodium--This is the generic name for one of the common medications used for migraine prevention (you can look up the brand name). It is pretty important to be on the 24 hour extended release tablets of this one, because the side effects are much less common with the extended release version.

Topiramate--This is the generic name for a common medication used for migraine prevention. Many people like this because it can cause modest weight loss in 1/5 people who take it. It also causes tingling in the hands in more than 50% of people who take it. It is important to start at a small dose and go up slowly to avoid side effects

Nortriptyline (and Amitriptyline)--These older medications can work at relatively low doses for migraine prevention. They were originally used to treat depression, but at much higher doses than we use for headache prevention

Trazodone--This is another older medication originally used for depression. It is pretty sedating, and can really help patients who have trouble sleeping and frequent headaches.

Gabapentin--This is helpful for some headache patients, but usually a 2nd or 3rd choice medication for headaches. Because it is also used for fibromyalgia, back pain and neuropathy pain, some patients may take it for more than one problem. Doses up to 3600 mg/day are "normal". It has no medication interactions, so is safe with other medications.

Pregabalin--this is the generic name of a medication that has been advertised heavily for diabetic peripheral neuropathy. It can help with headaches. It is often used with other medications haven't worked.

Zonisamide--This is a generic medication that is used to treat epilepsy (like Topiramate, Divalproex, Gabapentin, and Pregabalin). It can cause weight loss and tingling like Topiramate, but is less likely to cause memory problems. If you are allergic to Sulfa mediations, you cannot take it.

Levetiracetam--This is the generic version of a medication used to treat epilepsy. Its sometimes used for people with chronic daily headaches.

Tizanidine--This muscle relaxer is sometime used for headache prevention, usually in patients with chronic daily headaches, or tension headaches.
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crabapple22 responded:
When I changed from amitriptyline to topiramate in 2004, I lost 70 lbs. right away. I now have lost 112 lbs. (which is more than I weigh now) since changing. I have also changed my diet because I have high cholesterol which I am trying to control with my diet instead of medicine.
 
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scarbro222 responded:
I have taken everything on the list and more except the last few. (sub flexeril for the tizanidine) BTW....Botox in your face, head and neck HURTS!! Even spent several thousand dollars going to the Mayo Clinic in Rochester this past May seeking help to no avail. WHO or WHAT is going to help me?? Any ideas???
 
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BlessingsWater replied to scarbro222's response:
Have you ever tried ionized alkaline water? I know of a number of people that have tremendous relieft when they became ionized alkaline water drinkers. It is a very healthy solution to many health challenges, since acidity is being recognized as the primary cause of most health issues. And since the brain is a water based organ, the fluids we consume are essential to its health. Check out what doctors say: www.IonWaysPro.com/Blessings
 
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JoannaGirl replied to scarbro222's response:
Have you tried the mineral Magnesium? I take it most days and if I have a Migraine starting I take a tablet and it stops the progress of my attack. Worth a try. Let me know how you get on. I also dont find that taking drugs doesnt work and is worthwhile.
 
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AMBInspire replied to scarbro222's response:
I am reading about individuals having a lot of migraine success with COQ10. Has anyone else come accross this methodology?
 
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hawk2411 replied to BlessingsWater's response:
Have you tried hydrotherapy for your migraine such as a contrast shower with hot and cold or doing the same in a foot soak. Use two different tubs of water, one as hot as you can stand it and the other as cold as you can handle. Do 3 sets of 1 minute hot and 30 seconds cold soaking your feet, this draws the blood down from your head. I've tried it for my migraines and it works. Massage is also helpful. Hope that helps.
 
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StevaDe responded:
Adding at least 300 mg Magnesium, B2 and CoQ10 to your daily intake can lessen the frequency and severity. It may be mcg on one of those supplements. I also hear progesterone cream can prevent an oncoming migraine (I assume just for women). Hope this helps.
 
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12281948lucilee replied to scarbro222's response:
I've not been to the Mayo Clinic but the Diamond Headache Hospital in Michigan twice. I've also been on most of the meds listed and others. I am 62 and Migraines and headaches have ruled my life, my husbands (yes plural) and childrens lives. I know stress makes my Migraines worse. Putting a cold compress on your head helps, darkness and quiet and a man who loves you regardless. I can't exercise when I am in pain and I wake up with a headache every day. I try and walk every day but note the word "try". I had to go on Dissability because I couldn't work any longer and now my husband lost his job of 33 years due to the mess our country is in at this time. So yes I am under stress.
One releif is my grandchildren. they love me anyway.
The new medication Treximet does help me. I am on a new Medicare Supplement and do not know how much it will cost me yet. It is very expensive.
I remember my Mother taking me to the doctor when I was in grade school for headaches, so this not new to me. I got hurt in a GYM class and I beleive that is what started my problem. Surgeons have said they cannot isolate the problem and if they were wrong, I would be paralized. They won't touch me with a ten foot pole.
Relaxation techniques have shown some help for a short period of time. Self-hypnosis also has helped. And food allergies make everything worse, add gluten free to the mix-Yuck.
I wish I could tell you there is a magic pill. If there is, the closest for me is the Treximet. I am hoping I can get some next week. In the mean time, prayer, relaxation and love is all I have to help me.
Good luck and may God Bless you.
In my case, other ailments have complicated my health but I keep trying and praying.
 
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headachesallmylife responded:
I was on Topamax for 3.5 yrs. It worked fairly well at first but less as time went on. I had mild weight loss the whole time, blurry vision at times and tingling esp. in the beginning. The biggest problem by far was memory loss and cognitive deficits that almost cost me my job. This is NOT stressed enough in the literature, etc. (yes, I did start out very slowly). These side effects diminished completely after I weaned myself off. My question: How well does Zonisamide work vs. Topamax? I might be willing to try it if I could be sure that I wouldn't have cognitive side effects. Since discontinuing the Topamax I am right back to taking too many OTCs daily: acetaminophen w/caffeine, Naproxen, Excedrin; and Imitrex/Trexamet when I am in really bad shape. A percocet & Imitrex with sleep works the best for a migraine. I want to stop the rebound headaches. Please, help!
 
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nstephens1 replied to headachesallmylife's response:
I had a lot of trouble with Topamax. I think I may have been on it for maybe a week. I ended up blacking out and getting extremely violent. I would definetly not recommend it.
 
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KatrynS replied to headachesallmylife's response:
That's what scares me about topamax -- I'm a scientist so I can't work "stupid" -- three young kids have lowered my functioning IQ enough! <g> I moved and my new internist wouldn't try anything else since "only topamax works". I've decided to find a new Dr.
 
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skyblueandblack replied to crabapple22's response:
Weighing less than 112 lbs. is dangerous! That's nothing to brag about! Controlling one's weight is bringing it down (or up) to a healthy level. You need to talk to a doctor about why you feel you need to be so thin!
 
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An_204997 responded:
some great information here...thanks.
 
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sammi_cat responded:
I have been having Migraines since I was a small child without the auras but with nausea, extreme pain, and not much empathy from Medical professionals, family, or co-workers. I lost a lot of time, productivity, respect and ultimately employment from being a REAL Migraine sufferer.
A couple of years ago, when I was without insurance a wonderful Nurse Practitioner introduced me to Maxalt, (similar to Imitrex) and got me involved in their program for people on lesser incomes. I would say when I feel a Migraine approaching if I take a Maxalt immediately it does the trick. Sometimes after 30-45 minutes if I don't feel the symptoms abating I will take another. The only side effects I experience is a slight lightness of head and wooziness for up to 20 minutes. I would recommend everyone to ask their Doctor about this medication!

http://www.google.com/imgres?
imgurl=http://3.bp.blogspot.com/_1JXsL193h2w/SgoLh5uLRmI/AAAAAAAADR8/YQFSUYCwvoY/s640/DSC_5757WEB.jpg&imgrefurl=http://teachinfourth.blogspot.com/2009_05_01_archive.html&usg=__tVOS9oyvKowUKzITut2BAl6BaaA=&h=429&w=640&sz=54&hl=en&start=0&sig2=CgzTaZh139OpSUlCJ6eRSQ&zoom=1&tbnid=soafaOkGGlnfsM:&tbnh=144&tbnw=193&ei=YwvGTKXYEJKgsQPEzOT_DA&prev=/images%3Fq%3Dheadchaches-Maxalt%26hl%3Den%26biw%3D1024%26bih%3D653%26tbs%3Disch:1&itbs=1&iact=hc&vpx=709&vpy=266&dur=5207&hovh=184&hovw=274&tx=107&ty=203&oei=YwvGTKXYEJKgsQPEzOT_DA&esq=1&page=1&ndsp=12&ved=1t:429,r:11,s:0

Sincerely,
Lisa Ballard Powell
lisabpowell@gmail.com


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